Hospitalization Numbers Misleading?

At least 12,000 Amer­i­cans have already died from COVID-19 this month, as the coun­try inch­es through its lat­est surge in cas­es. But anoth­er wor­ry­ing sta­tis­tic is often cit­ed to depict the dan­gers of this moment: The num­ber of patients hos­pi­tal­ized with COVID-19 in the Unit­ed States right now is as high as it has been since the begin­ning of Feb­ru­ary. It’s even worse in cer­tain places: Some states, includ­ing Arkansas and Ore­gon, recent­ly saw their COVID hos­pi­tal­iza­tions rise to high­er lev­els than at any pri­or stage of the pan­dem­ic. But how much do those lat­ter fig­ures real­ly tell us?

From the start, COVID hos­pi­tal­iza­tions have served as a vital met­ric for track­ing the risks posed by the dis­ease. Last win­ter, this mag­a­zine described it as “the most reli­able pan­dem­ic num­ber,” while Vox quot­ed the car­di­ol­o­gist Eric Topol as say­ing that it’s “the best indi­ca­tor of where we are.” On the one hand, death counts offer final­i­ty, but they’re a lag­ging sig­nal and don’t account for peo­ple who suf­fered from sig­nif­i­cant ill­ness but sur­vived. Case counts, on the oth­er hand, depend on which and how many peo­ple hap­pen to get test­ed. Pre­sum­ably, hos­pi­tal­iza­tion num­bers pro­vide a more sta­ble and reli­able gauge of the pandemic’s true toll, in terms of severe dis­ease. But a new, nation­wide study of hos­pi­tal­iza­tion records, released as a preprint today (and not yet for­mal­ly peer reviewed), sug­gests that the mean­ing of this gauge can eas­i­ly be misinterpreted—and that it has been shift­ing over time.

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